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目的:探讨后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部梗阻的临床效果。方法:回顾性分析后腹腔镜离断式肾盂成形术治疗10例肾盂输尿管连接部梗阻患者的临床资料。其中男8例,女2例,年龄13~34岁。左侧7例,右侧3例;病程1周~5年,均为间断性腰部或腹部钝疼不适就诊。结果:10例手术均获成功,无中转开放手术病例。手术耗时90~240min,平均2h,术中出血35~80ml,术后2例出现漏尿,2~3d后停止,4~7d拔除腹膜后引流管,切口均一期愈合,术后6周拔出双J管,无漏尿及吻合口狭窄,随访3~30个月,B超及静脉肾盂造影检查提示积水改善、肾功能恢复。结论:后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部梗阻技术可行,安全有效,值得临床推广使用。
Objective: To investigate the clinical effect of retroperitoneal laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction. Methods: The clinical data of 10 patients with ureteropelvic junction obstruction treated with retroperitoneal laparoscopic segmental pyeloplasty were analyzed retrospectively. Including 8 males and 2 females, aged 13 to 34 years. 7 cases on the left and 3 cases on the right. The course of disease ranged from 1 week to 5 years. All of them were intermittent or obtuse abdominal pain. Results: All the 10 surgeries were successful without any cases of open surgery. Surgery took 90 ~ 240min, an average of 2h, intraoperative bleeding 35 ~ 80ml, 2 cases of postoperative leakage of urine, after 2 ~ 3d stop, 4 ~ 7d drainage retroperitoneal drainage, incision healed in one, postoperative 6 weeks A double J tube, no leakage of urine and anastomotic stenosis, followed up for 3 to 30 months, B ultrasound and intravenous pyelography examination showed improvement of hydronephrosis, renal function recovery. Conclusion: Retroperitoneal laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction is feasible, safe and effective, and is worthy of clinical application.